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At least 37 records · Page 2Linked to original sources

Giant papillary conjunctivitis with ocular prostheses.

In seven patients who each had either a methyl methacrylate corneal shell, a postenucleation ocular prosthesis, or a keratoprosthesis, giant papillary conjunctivitis of the tarsus of the upper lids developed after prolonged wear. These cases expand the spectrum of disease that was initally described in wearers of hard and soft contact lenses. The papillary changes in prostheses wearers did not always produce symptoms and were not readily reversible. Basophils and mast cells characterized the inflammatory infiltrate, suggestng an antigen-antibody mechanism underlying the response. Increased production of epithelial mucin, in contrast to goblet cell mucin, may play a role in producing symptoms in this syndrome.

Adolescent

Orbital cellulitis due to Neisseria gonorrhoeae in an enucleated socket.

Orbital cellulitis due to Neisseria gonorrhoeae developed in an adolescent girl in a previously enucleated socket. Since this organism also was isolated from her pharynx, the orbital infection probably resulted from contamination of the prosthesis by gonococci from her mouth, either directly or by transfer from her fingers.

Adolescent

Ocular enucleation in a patient with severe classic hemophilia A.

A 27-year-old man with severe classic hemophilia A (antihemophilic globulin level: 1.5% of normal) had blunt trauma to his left eye that produced a corneoscleral laceration with prolapse of the intraocular contents. His left eye was enucleated under management with factor VIII replacement. This consisted of sufficient cryoprecipitate to increase the calculated circulating factor VIII level to 125%, sufficient factor VIII every 12 hours to increase peak postinfusion levels from 100 to 120%, and to maintain minimum levels of 30% immediately before infusion. Because he had developed a gingival hematoma when he was placed on epsilon amino caproic acid after only one day of factor VIII replacement following extraction of mandibular molars, we continued the high level of factor VIII replacement for five days and then began antifibrinolytic epsilon amino caproic acid therapy. His surgical and postoperative course were uneventful on this regimen.

Adult

Surgical correction of superior sulcus deformity occurring after enucleation.

A prefabricated, sculptured, subperiosteal orbital floor implant was used in six cases of cosmetically unacceptable deep superior eyelid sulcus that occurred after enucleation. The implant provided anterior and superior displacement of orbital contents. Surgical placement was similar to the approach for implant placement in orbital floor fracture and provided satisfactory cosmetic and functional results.

Eye, Artificial

Uses of RTV silicone in orbital reconstruction.

In a five-year follow-up of 42 patients with unsatisfactory cosmetic results after enulceation, room-temperature vulcanizing (RTV) silicone was used in the surgical correction of enophthalmos and superior sulcus depression. RTV silicone with a catalyst was placed in a dissected pocket subperiosteally along the floor and lateral wall of the orbit to correct the volume deficit. When vulcanizing in situ into soft silicone rubber, the implant conformed to the orbital wall and did not migrate. We determined tissue tolerance to in situ vulcanizing silicone histologically in 30 rats by inserting prevulcanized and in situ vulcanized material in paired subcutaneous pockets. No statistical difference was noted between the two methods. In 11 cases, the same material was used as a convenient stent to maintain the pressure over a graft and to maintain socket size after the reconstruction of a contrated socket, by filling the socket with RTV silicone which surrounded a Kirschner wire drilled through the lateral orbital rim.

Animals

Mechanical and systems approach facilitating facial prosthesis production.

A method of facilitating facial prosthesis production using specially designed equipment and a color notation record has been described. Application to facial and auricular prosthesis production has been discussed. Advantages in time saved and staff utilization have been realized through the use of this approach.

Color